Antibiotic Resistance Threats in the United States, 2013 report

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FLUCONAZOLE-RESISTANT CANDIDA FIGHTING THE SPREAD OF RESISTANCE Prevention strategies for candidemia are not well defined. Most infectious are thought to be caused by Candida that the patient carries on his or her own body. Therapy to prevent infections (antifungal prophylaxis) may be appropriate for some groups at high risk of developing Candida bloodstream infection, such as low-birth-weight infants. CDC recommendations for catheter care and handwashing can be helpful in reducing transmission in healthcare institutions. WHAT CDC IS DOING Prevention of significant morbidity and mortality from candidemia remains a challenge. Although antifungal prophylaxis has been shown to be effective in selected patient populations, there is still debate on the application of risk prevention tools and other prevention strategies. There is a continued need for surveillance of candidemia to develop and evaluate prevention strategies and to monitor for changes in incidence and resistance. Changes Over Time in Incidence of Resistant Species of Candida There is increasing incidence of Candida infections due to azoleand echinocandinresistant strains. *This accounts for data collected from Atlanta, GA from 1992-1993 and from Baltimore, MD from 1998–2000. **This accounts for data collected from 2008–present. ONLINE RESOURCES CDC’s candidiasis website http://www.cdc.gov/fungal/candidiasis/ CS239559-B
EXTENDED SPECTRUM β-LACTAMASE (ESBL) PRODUCING ENTEROBACTERIACEAE 26,000 1,700 DRUG-RESISTANT INFECTIONS DEATHS 140,000 ENTEROBACTERIACEAE INFECTIONS PER YEAR THREAT LEVEL SERIOUS This bacteria is a serious concern and requires prompt and sustained action to ensure the problem does not grow. $40,000 IN EXCESS MEDICAL COSTS PER YEAR FOR EACH INFECTION Extended-spectrum β-lactamase is an enzyme that allows bacteria to become resistant to a wide variety of penicillins and cephalosporins. Bacteria that contain this enzyme are known as ESBLs or ESBLproducing bacteria. ESBL-producing Enterobacteriaceae are resistant to strong antibiotics including extended spectrum cephalosporins. RESISTANCE OF CONCERN Some Enterobacteriaceae are resistant to nearly all: ■■ penicillins ■■ cephalosporins In these cases, the remaining treatment option is an antibiotic from the carbapenem family. These are drugs of last resort, and use of them is also contributing to resistance (see CRE fact sheet). ■■ ■■ Nearly 26,000 (or 19%) healthcare-associated Enterobacteriaceae infections are caused by ESBL-producing Enterobacteriaceae. Patients with bloodstream infections caused by ESBL-producing Enterobacteriaceae are about 57% more likely to die than those with bloodstream infections caused by a non ESBL-producing strain. PUBLIC HEALTH THREAT An estimated 140,000 healthcare-associated Enterobacteriaceae infections occur in the United States each year. CDC estimates that bloodstream infections caused by ESBLcontaining Enterobacteriaceae result in upwards of $40,000 in excess hospital charges per occurrence. Approximately 26,000 infections and 1,700 deaths are attributable to ESBLs. ESBL-producing Klebsiella spp. Percentage of Enterobacteriaceae healthcare-associated infections resistant to extended spectrum cephalosporins Estimated number of infections Estimated number of deaths attributed 23% 17,000 1,100 ESBL-producing E. coli 14% 9,000 600 Totals 26,000 1,700 For more information about data methods and references, please see technical appendix.
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ANTIBIOTIC RESISTANCE THREATS in th
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ACINETOBACTER 4
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ANTIBIOTIC RESISTANCE THREATS IN TH
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the risk of antibiotic-resistant in
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THE THREAT OF ANTIBIOTIC RESISTANCE
Page 13 and 14: NATIONAL SUMMARY DATA Estimated min
Page 15 and 16: Minimum Estimates of Morbidity and
Page 17 and 18: Antibiotic- Resistant Microorganism
Page 19 and 20: ■■ For several pathogens, compl
Page 21 and 22: In general, threats assigned to the
Page 23 and 24: Drug Class Important Characteristic
Page 25 and 26: Antibiotic Safety ANTIBIOTICS ARE R
Page 27 and 28: GAPS IN KNOWLEDGE OF ANTIBIOTIC RES
Page 30 and 31: CANDIDA 30
Page 32 and 33: 1. PREVENTING INFECTIONS, PREVENTIN
Page 34 and 35: CDC’s Work to Prevent Antibiotic
Page 36 and 37: Preventing Infections: CDC’s Work
Page 38 and 39: ■■ ■■ ■■ Strengthening
Page 40 and 41: Tracking Networks Data Collected Re
Page 42 and 43: Antibiotic Prescriptions per 1000 P
Page 44 and 45: 4. DEVELOPING NEW ANTIBIOTICS AND D
Page 46: Drug Name Year Approved Key Targete
Page 49 and 50: CURRENT ANTIBIOTIC RESISTANCE THREA
Page 51 and 52: CLOSTRIDIUM DIFFICILE 250,000 INFEC
Page 53 and 54: CARBAPENEM-RESISTANT ENTEROBACTERIA
Page 55 and 56: DRUG-RESISTANT NEISSERIA GONORRHOEA
Page 58 and 59: THREAT LEVEL SERIOUS MICROORGANISMS
Page 60 and 61: MULTIDRUG-RESISTANT ACINETOBACTER F
Page 62 and 63: DRUG-RESISTANT CAMPYLOBACTER FIGHTI
Page 66 and 67: EXTENDED SPECTRUM β-LACTAMASE (ESB
Page 68 and 69: VANCOMYCIN-RESISTANT ENTEROCOCCUS (
Page 70 and 71: MULTIDRUG-RESISTANT PSEUDOMONAS AER
Page 72 and 73: DRUG-RESISTANT NON-TYPHOIDAL SALMON
Page 74 and 75: DRUG-RESISTANT SALMONELLA SEROTYPE
Page 76 and 77: DRUG-RESISTANT SHIGELLA FIGHTING TH
Page 78 and 79: METHICILLIN-RESISTANT STAPHYLOCOCCU
Page 80 and 81: DRUG-RESISTANT STREPTOCOCCUS PNEUMO
Page 82: DRUG-RESISTANT TUBERCULOSIS FIGHTIN
Page 85 and 86: VANCOMYCIN-RESISTANT STAPHYLOCOCCUS
Page 87 and 88: ERYTHROMYCIN-RESISTANT GROUP A STRE
Page 89 and 90: CLINDAMYCIN-RESISTANT GROUP B STREP
Page 92 and 93: 92 EXTENDED SPECTRUM β-LACTAMASE P
Page 94 and 95: Technical Appendix Clostridium diff
Page 96 and 97: The number of deaths attributable t
Page 98 and 99: Technical Appendix Drug-Resistant C
Page 100 and 101: Technical Appendix Drug-Resistant S
Page 102 and 103: Technical Appendix Methicillin-Resi
Page 104 and 105: Technical Appendix Drug-Resistant S
Page 106 and 107: Technical Appendix Clindamycin-Resi
Page 108 and 109: Bacteria: Single-celled organisms t
Page 110 and 111: in people allergic to penicillin, b
Page 112 and 113: ACKNOWLEDGEMENTS Many people in the
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CS239559-B
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Antibiotic Resistance Threats in the United States, 2013 report

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